| Advances in Hepatobiliary Imaging |
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Monday 20 April 2009 |
| Room 316A |
16:30-18:30 |
Moderators: |
Elizabeth M. Hecht and Claude B. Sirlin |
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16:30 |
110. |
MR Elastography of Dynamic
Postprandial Hepatic Stiffness Augmentation in
Chronic Liver Disease |
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Meng Yin1,
Jayant A. Talwalkar2, Sudhakar K.
Venkatesh3, Richard L. Ehman1
1Department of Radiology, Mayo Clinic,
Rochester, MN, USA; 2Division of
Gastroenterology & Hepatology , Mayo Clinic,
Rochester, MN, USA; 3Diagnostic
Radiology, National University of Singapore,
Singapore |
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This preliminary
investigation provides evidence that MRE-assessed
hepatic stiffness in patients with chronic liver
disease has a dynamic component that can increase
following a test meal. This may reflect the
transient increase in portal pressure that is known
to occur in some of these patients postprandially.
If confirmed, these findings will provide motivation
for further studies to determine the potential value
of assessing postprandial hepatic stiffness
augmentation for predicting progression of fibrotic
disease and the development of portal varices. The
technique may also provide new insights into the
natural history and pathophysiology of chronic liver
disease. |
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16:42 |
111. |
Carbogen Gas-Challenge BOLD
MRI in Rat Liver Fibrosis Model |
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Ning Jin1,2,
Jie Deng1,3, Tamuna Chadashvili4,
Yue Zhang4,5, Yang Guo4,
Guangyu Yang6, Reed Omary2,4,
Andrew C. Larson1,2
1Department of Radiology , Northwestern
University, Chicago, IL, USA; 2Department
of Biomedical Engineering, Northwestern University,
Chicago, IL, USA; 3Department of Medical
Imaging, Children's Memorial Hospital, Chicago, IL,
USA; 4Department of Radiology,
Northwestern University, Chicago, IL, USA; 5Department
of Bioengineering, University of Illinois Chicago,
Chicago, IL, USA; 6Department of
Pathology, Northwestern University, Chicago, IL, USA |
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Hepatic fibrosis is a
dynamic and reversible process leading to regional
and global blood perfusion alteration. We hypothesis
that in the setting of liver fibrosis BOLD signal
changes between normal and hyperoxia conditions
would be reduced. In this work, a negative
correlation was found between the BOLD response to
gas-challenge and the degree of liver fibrosis.
Gas-challenge BOLD MRI is a potential non-invasive
method for liver fibrosis diagnosis and staging. |
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16:54 |
112. |
T1ρ-Based MR Imaging for the
Non-Invasive Quantification of Extracellullar Matrix
Protein Concentration in Hepatic Fibrosis |
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Dania Daye1,
Chenyang Wang, Eric Mellon2, Santosh
Gaddam3, Rebecca Wells4, Emma
Furth5, Ravinder Reddy3
1Department of Bioengineering, University of
Pennsylvania, Philadelphia, PA, USA; 2Department
of Biophysics and Molecular Biochemistry, University
of Pennsylvania; 3Department of
Radiology, University of Pennsylvania; 4Department
of Medicine, University of Pennsylvania; 5Department
of Pathology and Laboratory Medicine, University of
Pennsylvania |
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While hepatic cirrhosis
is a major leading cause of adult death in the US,
the gold standard to diagnose and monitor the
progress of patients afflicted with this condition
remains limited to liver biopsy. Biopsies, however,
an often irreproducible and plagued with many
complications. T1ρ-based MR imaging is a technique
that has previously shown promise in quantifying
macromolecular concentration. Given that liver
fibrosis manifests as a progressive deposition of
extracellular matrix proteins, we hypothesized that
T1ρ imaging can be used to quantify protein
deposition in fibrosis. Our preliminary results show
that T1ρ imaging might have significant potential to
provide for a quantitative and non-invasive
assessment of hepatic fibrosis. |
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17:06 |
113. |
In Vivo Assessment of Hepatic
Ischemia/Reperfusion Injury in Rat Using Diffusion
Tensor Imaging |
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Jerry S. Cheung1,2,
Shu Juan Fan1,2, April M. Chow1,2,
Edward S. Hui1,2, Ke Xia Cai1,2,
Kwan Man3, Ed X. Wu1,2
1Laboratory of Biomedical Imaging and Signal
Processing, The University of Hong Kong, Hong Kong
SAR, China; 2Department of Electrical and
Electronic Engineering, The University of Hong Kong,
Hong Kong SAR, China; 3Department of
Surgery, The University of Hong Kong, Hong Kong SAR,
China |
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Hepatic
ischemia/reperfusion injury (IRI) occurs during
liver transplantation, tumor resection, hemorrhagic
shock and veno-occlusive disease, and is a major
cause of acute liver failure. IRI in liver is also
responsible for early organ failure and increased
incidence of both acute and chronic rejection after
liver transplantation. This study aims to examine
the changes of diffusion measurements by diffusion
tensor imaging (DTI). The experimental results
demonstrated that DTI is useful in identifying
hepatic IRI by characterizing the transient changes
in mean diffusivity and fractional anisotropy. |
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17:18 |
114. |
Combined T2-Weighted and MRCP
3D Imaging of the Abdomen Using a Dual-Contrast
Single-Slab 3D-TSE Pulse Sequence |
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John
P. Mugler, III1, Wilhelm Horger2,
Berthold Kiefer2
1Radiology, University of Virginia,
Charlottesville, VA, USA; 2Siemens
Healthcare, Erlangen, Germany |
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This work explored the
feasibility of acquiring both T2-weighted and MRCP
images within the same 3D turbo-spin-echo (TSE)
acquisition. By using a very long flip-angle train
of up to 400 echoes that includes variable and
constant flip-angle segments, T2-weighted and
heavily T2-weighted (MRCP) high-resolution, 3D image
sets of the abdomen were obtained with a single
3D-TSE acquisition in a clinically-acceptable
acquisition time of 5-7 minutes. This approach has
the potential to improve the quality and efficiency
of diagnostic evaluation of the abdomen using MRI. |
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17:30 |
115. |
MRCP After the Injection of
Gd-EOB-DTPA: Are 3 Minutes Safe for T2 Weighted
Navigated 3D MRCP? |
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Kristina Ringe1,
R Gupta2, Angela Reichel1,
Thomas Rodt1, Sabine Dettmer1,
Nils Hellige3, Michael Galanski4,
Elmar M. Merkle2, Joachim Lotz5
1Department of Radiology, Hannover Medical
School, Hannover, Germany; 2Department of
Radiology, Duke University School of Medicine,
Durham, NC, USA; 3Department of
Radiology, Hannover Medical School, Hannover,
Germany; 4Department of Radiology,
Hannover Medical School, Hannover, Germany; 5Department
of Radiology, Hannover Medical School, Hannover ,
Germany |
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T2-weighted respiration
navigated MRCP was performed before and 3.3+/-0.4min
after administration of GD-EOB-DTPA in 21 patients.
SNR in bile ducts was assessed to quantify
alterations in the quality of MRCP induced by
biliary excretion of the contrast agent. SNR
decreased by 26.5 +/- 33.5% in the MRCP after the
injection of GD-EOB. Maximal decrease of SNR was 90%
making the MRCP non-diagnostic. A non-significant
tendency for larger decreases of SNR in younger
patients and preserved SNR in patients with
parenchymal disease was seen. GD-EOB-DTPA should be
injected after a T2w-MRCP to avoid negative effects
on the quality of the MRCP. |
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17:42 |
116. |
Combining Diffusion-Weighted
MR Imaging with Gd-EOB-DTPA Enhanced MR Imaging
Improves the Detection of Colorectal Liver
Metastases |
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Dow-Mu Koh1, Toni Wallace1,
Erica Scurr1, David J. Collins1,2,
Angela Riddell1
1Department of Radiology, Royal Marsden
Hospital, Sutton, Surrey, UK; 2CR UK
Clinical Magnetic Resonance Research Group,
Institute of Cancer Research, Sutton, Surrey, UK |
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The combination of
diffusion-weighted MR imaging with Gd-EOB-DTPA
enhanced T1-weighted MR imaging resulted in the
highest diagnostic accuracy for the detection of
colorectal liver metastases compared with either
technique on its own. Combining both techniques
appear to be optimum for defining the burden and
distribution of liver metastases in patients with
colorectal cancer to inform management strategies. |
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17:54 |
117. |
Ultra High Spatio-Temporal
Resolution Hepatic MRI Using a Novel 2-Point Dixon
Time Resolved 3D SPGR Sequence at 3T |
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Manojkumar Saranathan1,
Dan Rettmann1, Ersin Bayram2,
Christine Lee3, James Glockner3
1Applied Science Laboratory, GE Healthcare,
Rochester, MN, USA; 2MR Engineering, GE
Healthcare, Waukesha, WI, USA; 3Dept. of
Radiology, Mayo Clinic, Rochester, MN, USA |
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Dynamic contrast
enhanced MRI (DCEMRI) is commonly used in
abdominal-pelvic imaging for detection and
characterization of primary and metastatic lesions.
It affords adequate spatial resolution but the
temporal resolution is often insufficient. Optimal
timing of the contrast arrival is critical in
capturing the arterial phases and in improving
lesion conspicuity. Traditional fat suppression
methods perform suboptimally at 3T due to Bo and B1
inhomogeneities, causing non-uniform fat suppression
across the image and signal loss. We report clinical
results of a novel DCEMRI technique called META
(Multi-Echo Tricks Acquisition) that combines a
multi-echo TRICKS scan with a two-point Dixon
fat-water reconstruction algorithm to generate
fat-only and water-only time resolved images at very
high spatio-temporal resolution. META was scanned on
23 patients referred for hepatic MRI. |
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18:06 |
118. |
Diffusion-Weighted MR Imaging
(DWI) Using TRacking Only Navigator Echo (TRON):
Initial Clinical Evaluation and Comparison to
Respiratory Triggered and Free Breathing DWI |
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Thomas Kwee1,
Taro Takahara1, Tetsuo Ogino2,
Gwen Herigault3, Maarten van Leeuwen1,
Willem Mali1, Peter Luijten1
1Department of Radiology, University Medical
Center Utrecht, Utrecht, Netherlands; 2Philips
Healthcare, Tokyo, Japan; 3Philips
Healthcare, Best, Netherlands |
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Respiratory triggered (RT)
and free breathing (FB) diffusion-weighted MR
imaging (DWI) of the liver suffer from a prolonged
examination time and image blurring, respectively.
The TRacking Only Navigator echo (TRON) technique
allows continuous real-time slice tracking and may
be an excellent alternative. In this study,
conspicuity of liver metastases (N=14) between TRON,
RT, and FB DWI was equal, while actual scan time of
RT DWI was two to three times longer and FB DWI
inherently suffers from image blurring.
Reproducibility of ADC measurements of liver
metastases among TRON, RT and FB DWI was moderate to
poor. |
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18:18 |
119. |
Clinical Liver MRI at 3.0
Tesla Using Parallel RF Transmission with
Patient-Adaptive B1 Shimming |
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Guido Matthias Kukuk1,
Jürgen Gieseke1,2, Michael Nelles1,
Roy König1, Magnus Andersson1,
Eugen Muschler1, Petra Mürtz1,
Jeroen Stout2, Marco Nijenhuis2,
Frank Träber1, Nuschin Morakkabati-Spitz1,
Daniel Thomas1, Christiane Katharina Kuhl1,
Hans Heinz Schild1, Winfried Albert
Willinek1
1Department of Radiology, University of Bonn,
Bonn, NRW, Germany; 2Philips Healthcare,
Best, Netherlands |
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The clinical
implementation of high field MRI systems has
introduced new challenges for body imaging with
respect to B1 field non-uniformities, generation of
standing waves and signal loss particularly in
abdominal imaging. To achieve a more homogeneous
excitation we evaluated patient-adaptive RF shimming
using parallel RF transmission for liver imaging in
22 patients at 3.0 Tesla. Our data demonstrate a
significant improvement of image quality and lesion
conspicuity in T2-TSE sequences and DWI. |
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